The overall goal of this revised NIA Academic Career Leadership award is to develop a research program at UAB addressing Advanced Illness and Multimorbidity (AIM), the natural nexus of geriatrics and palliative care. Advanced illness (the state of having a serious, incurable, progressive disease) and multimorbidity (the simultaneous existence of more than one pathophysiologic condition) often co-occur in geriatric patients. Together, AIM impact quality of life for many older adults, often leading to increasing interactions with the health care system, and curtailing independent living and longevity. Increasing attention is being devoted to multimorbidity, but less is known about optimal management of multimorbidity at the end of life. Because the number of older adults experiencing AIM is increasing, better understanding of AIM and interventions to support patients with AfM has the potential to improve care and quality of life for older adults. UAB already has a large pool of talented researchers investigating clinical issues related to specific diseases or geriatric syndromes. A research program interrelating conditions and addressing illness burden related to advanced stage diseases and multimorbidity will fill important gaps in our current understanding of care for older people. To that end, the objectives of the AIM Research Program include the following: 1) To conduct research in Advanced Illness Care to improve processes and outcomes of care for older people, especially those with AIM; 2) To build research capacity in the Schools and Centers at UAB through expansion and integration of academic training in AIM for trainees, junior and transitional faculty; 3) To facilitate long term sustainability of an AIM Research Program that fosters opportunities for faculty development, collaboration and productive research across the University; and to 4) To foster the pedagogical and leadership skills of the proposed Director of the AIM Research Program, Dr. Christine Ritchie. The AIM Research Program objectives will directly target unmet needs in aging research by addressing cross-cutting and interrelated issues across diseases, geriatric syndromes and settings of care that are highlighted by the experience of advanced illness. Improved understanding of the challenges and solutions to advanced illness care through this interdisciplinary research program will potentially result in profound improvements in both the quality of health care received and experienced by older adults.